[Experimental comparative evaluation of the functional capacities of ectopically grown fetal organs].

The interest for fetal organ, tissue, and cell implantation as therapeutic means in the treatment of some diseases is presently increasing. Hence, the aim of the present investigation was the comparative evaluation of the functional potential of ectopically grown fetal organs of different (ecto-, meso- and endodermic) origins. Unified operative model was the fetal organ fragment implantation into an ear subcutaneous pouch (without restoration of vascular and nervous links of the implant with the recipient organism). The implant isolation in vitro varied from 15 to 50 min. As control, intact animals and animals with streptozotocin diabetes and hepatic lesions due to the main bile duct ligature, were used. The implanted and ectopically grown fetal organs, though of different origins, developed functional activity. The best adult-like function was obtained in intestinal, gastric and cardiac implants, i.e. in organs with a cavity and a well developed self-regulation system. Poorer results were obtained in great digestive glandular implants--pancreas and liver. In the best cases when the implant function was very closed to the adult organ, a difference nevertheless was observed. The model of ectopic implantation of fetal organs may be useful for study of the organ and tissue function ontogenesis (up to the moment of natural ageing involution), for the evaluation of different isolated factor influence on organ and tissue physiology and pathology. Although being optimistic in respect to clinical application of fetal organ and cell implantation, this study does not prevent us from being cautions.

[Diagnosis of pulmonary embolism]. / Diagnostic de l'embolie pulmonaire.

A good knowledge of clinical presentation and of risk factors for pulmonary embolism is mandatory to improve adequate clinical suspicion. Some recent improvements in diagnostic strategy have to be emphasized. A low D-dimer level has a good negative predictive value to rule out pulmonary embolism. Ventilation-perfusion lung scan is the most often used imaging technique. In case of non diagnostic scan, serial non invasive search for deep vein thrombosis in the limbs is recommended by some experts at least in patients with good cardio-respiratory reserve, pulmonary angiography being recommended otherwise. Spiral CT allows direct demonstration of clots, being hardly less sensitive than pulmonary angiography except for subsegmental emboli. Future perspectives include the use of spiral CT as first choice procedure, as well as magnetic resonance imaging.